Is Angina the Precursor to a Heart Attack?

Chest pain can be a signal that something is seriously wrong, but far too many individuals ignore chest pain or wait too long to be seen by a medical professional. Sometimes, people assume mild chest pain is unrelated to their heart because it comes and goes. In other cases, it’s simpler to write off intermittent chest pain as muscle spasms, heartburn, or simple anxiety. However, it’s critical to protect your heart health by having chest pain evaluated by a medical professional as soon as possible.  

At West Houston Heart Center, located in Houston, Texas, cardiologist Dr. Humayun Naqvi provides a comprehensive range of heart health and interventional cardiac services. We can accurately evaluate your episodes of angina and let you know if you’re at risk for heart attack.

Angina basics

Angina is a specific type of chest pain caused by a lack of blood flow to your heart. The most common cause of angina is coronary artery disease (CAD), although there are other potential culprits that cause narrowing of your arteries.

CAD develops when cholesterol and other fats build up in your arteries, slowing the flow of oxygen-rich blood to your heart. Cholesterol plaque grows over the years, until it chokes the arteries and causes severe oxygen deprivation. This leaves your heart struggling to work and causes intermittent chest pain. 

Types of angina 

There are three main types of angina:

1. Stable angina

Blocked coronary arteries typically cause stable angina, which is chest pain triggered by activity. You may notice chest pain when you’re walking, climbing stairs, or carrying things. You can also have additional symptoms like pain in your jaw, neck, back, and/or arms, or a sensation of heaviness or pressure inside your chest. You should schedule an appointment with your doctor as soon as possible to address stable angina.

2. Unstable angina

Sudden, unexpected chest pain is a sign of unstable angina and requires immediate medical attention. Rest or medication such as nitroglycerin tablets don’t help, because unstable angina is caused by a completely blocked coronary artery or a blood clot. An unstable angina episode can happen whether you're resting or being active.  

3. Prinzmetal angina

Younger people who have intermittent chest pain are more likely to have what is called variant, vasospastic, or Prinzmetal angina. Unlike the other two main types of angina, this isn’t caused by blocked arteries. Instead, it’s a spasm in the coronary arteries, which can usually be traced to:

• High levels of stress and/or anxiety
• Smoking or cocaine use
• Sudden exposure to cold temperatures
• Certain medications that tighten blood vessels

Prinzmetal angina often occurs at night when you’re at rest. You can keep it under control with medication and by avoiding triggers.

Angina and heart attack risk

All types of angina can increase your risk of heart attack. Depending on the type of angina you experience and how severe your episodes are, you may need to take medication, change your lifestyle, have a stent inserted to help keep an affected artery open, or undergo cardiac surgery.

Angina should always be treated as a possible precursor to a heart attack, and you should take action accordingly. While some people don’t have early signs and end up having angina and a heart attack simultaneously, in many cases angina acts as an early warning system that allows more time to save your life. 

If you’ve experienced chest pain, it’s time to see a professional. To schedule an appointment with Dr. Naqvi and his team at the West Houston Heart Center, call 832-400-3957, or request an appointment online.